WIDER SOCIETY

Question 1

F: DISTRIBUTIVE JUSTICE

Answer 1

• Must ensure patients treatment is the most efficient and effective for their condition.
  One patient receiving treatment shouldn’t deprive another entirely.
  NICE: An organisation that passes recommendations for drug usage for medical professionals to follow. It evaluates the benefit of the drug on the individual as cost-effectiveness for the NHS.
  1 QALY must cost no more than £12k

Question 2

F: HOLISTIC CARE

Answer 2

• Doctor’s must consider the effects of a patients illness or treatment on their family, job, hobbies, education, driving, pets.
  OCCUPATIONAL THERAPIST must factor for this when considering possible treatment pathways.
• Parkinson’s Arthritis: Must treat symptoms whilst accomodating patients daily activities.

Question 3

F: CONFIDENTIALITY BREACH

Answer 3

• when the patient may be at risk to the wider society or themselves
  PUBLIC INTERESTS:
  The Mental health act - allows patients with mental health or psychiatric problems can be sectioned. Remove a patient’s autonomy to protect society at large.
  Changes in eyesight: if a patient is unwilling, the doctor can disclose to the DVLA.
  DISEASE NOTIFICATIONS:
  The patient diagnosed with HIV doesn’t wish to tell their partner. A doctor can be break confidentiality to tell the partner.

Question 4

F: FAMILY AND SOCIAL HISTORY

Answer 4

Wider society: could be a patient’s family.
- E.g. patient with a lump has a family history of breast cancer.
Important to consider the family history to inform a patient’s diagnosis.

Social history: where a patient lives, their occupation. Their ethnicity
Certain ethnic groups are more susceptible to certain conditions.
Example: QRISK3: clinical tool which allows doctors to assess a patient’s cardiovascular risk. Includes ethnicity.
So by considering the wider population’s history of cardiovascular events (e.g. heart attack) you can more inform decisions about one patient’s risk and what medications they should be given.

Question 5

A: BENEFICENCE

Answer 5

Giving the best quality of care to the patient before you.
Beneficence: duty of care to act in the patient’s best interests
Clear-doctor patient relationship
Patients should have the autonomy to make decisions irrespective of the opinion of their society or family.

Question 6

A: Confidentiality

Answer 6

Confidentiality is a sacred part of the doctor-patient relationship.
Ensures that patient can trust the doctor, so will turn up to appointments and feel that they can provide the information needed for a diagnosis
Should not be breached if:
Patient is competent
Gillick competence and Fraser guidelines: used to assess the competence of children under 16, over 13. Can be used to provide sexual healthcare without parental knowledge.
Important for safeguarding
Women’s choice. A pregnant woman can have an abortion or can have her tubes tied, without having to inform her partner.
Right to abortion, irrespective of the opinion of society.

Question 7

A: PATIENT NEEDS

Answer 7

Police:
Unless there is a serious risk to the public, doctors do not have to disclose crimes to the police
Important with IV drug use
Patient’s may not present if addicted to illicit drugs, but these groups have important healthcare needs
More vulnerable to HIV and certain types of viral hepatitis